1st international workshop on colon capsule endoscopy

1ST 

INTERNATIONAL 

WORKSHOP ON 

COLON CAPSULE 

ENDOSCOPY 

Workshop Report Vol. 1 

Detecting Colonic Polyps and Cancer 

Page 2: Results and analysis of the European multicenter 

study of colon capsule endoscopy (CCE) with 

PillCam COLON 

Colon Capsule Endoscopy Regimen 

Page 3: Baseline prep and procedure; overview of 

ongoing research 

IBD and Mucosal Healing 

Page 4, 5: Assessment of colonic inflammatory lesions; 

interim analysis of multicenter study on ulcerative 

colitis (UC); CCE and incomplete colonoscopy 

Economics of CRC Screening 

Page 6: Economic modeling data on cost-effectiveness 

of PillCam COLON for colorectal cancer (CRC) 

screening compared to colonoscopy 

CRC Screening and Other Indications 

Page 7: Clinical cases using colon capsule endoscopy 

for CRC screening and other indications 

complementing colonoscopy 

Workflow and Practical Guidelines 

Page 8: Highlights of how CCE can fit into the workflow 

of a GI practice 

Visit www.ICCE.info 

for consensus material and archives of 

abstracts and ICCE Reports. 

To receive updates on ICCE events, 

click the Contact Us link. 

*PillCam COLON has received a CE Mark, but is not cleared for 

marketing or available for commercial distribution in the USA. 

Now in its seventh year, the International 

Conference on Capsule Endoscopy 

(ICCE) remains the preeminent 

symposium for capsule endoscopy 

(CE). As a result of physician interest, 

a dedicated, interactive <strong>international</strong> 

<strong>workshop</strong> was held for the first time to 

focus on the emerging modality of colon 

capsule endoscopy. This publication, the 

ICCE Workshop Report Vol. 1, is a summary 

of selected presentations and scientific talks from the <strong>workshop</strong>. 

The <strong>1st</strong> ICCE Workshop on Colon Capsule Endoscopy convened in Berlin, 

Germany and was co-chaired by G. Costamagna (Italy) and W. Schmiegel 

(Germany). With joint sponsorship by Given Imaging and Fujinon, the 

ICCE is still the only <strong>international</strong> congress focusing entirely on capsule 

endoscopy. Over 200 physicians and medical professionals from 32 

countries came to this year’s dedicated <strong>workshop</strong> to learn more about 

colon capsule endoscopy (CCE) and PillCam® COLON. 

Presentations included recent scientific data on using PillCam COLON to 

evaluate colonic mucosa. Topics included colorectal cancer, colon polyps, 

colonic inflammatory lesions and ulcerative colitis, scoring indexes for 

characterizing colonic mucosal damage and healing, and regimens (prep 

and procedures) for CCE. There were lively discussions on economics and 

optimizing the utility of CCE in current clinical practice and potential 

screening applications. Several sessions also emphasized the ongoing 

impact of the updated ICCE Consensus, published in Endoscopy, and CE 

for the esophagus and small bowel. 

Also at the Berlin meeting, ICCE Learning Center activities included 

hands-on demonstrations of the Given Imaging PillCam Platform’s new 

RAPID® software features for image-enhancement and RAPID Access 

for CE in a networked environment; as well as the latest techniques for 

double-balloon endoscopy (DBE) from Fujinon. This year’s European 

Capsule Endoscopy Group (ECEG) Research Grants were awarded at the 

Berlin meeting (see page 8). 

For more information on the ICCE, visit the website www.ICCE.info for 

summaries (including issues of the ICCE Conference Report), consensus 

material, and an abstract archive. The website is also accessible from the 

www.CapsuleEndoscopy.org homepage.

2 ICCE Workshop Report Vol. 1 


The European multicenter study data presented by J. Devière 

(Belgium) at the <strong>1st</strong> International Workshop on Colon 

Capsule Endoscopy represents the largest clinical study to 

date on CCE. Principal investigator of the PillCam COLON 

feasibility and pilot studies R. Eliakim (Israel) introduced 

Devière’s lecture and the scientific sessions with a quote from 

the American Gastrological Association (AGA) Future Trends 

Report, Gastroenterology (2006; 131:1287-1312): 

“Wireless capsule endoscopy represents one of the most 

significant and exciting breakthroughs in endoscopic 

technology in recent years. The capsule has clearly 

revolutionized small bowel imaging… A version for 

imaging the colon is under study and, if proven effective, 

will clearly represent a second revolution in bowel imaging.” 

This potential for CCE as an effective tool was reinforced by 

C. Hassan (Italy) in his presentation of economics modeling 

data (on page 6). 

PillCam COLON Capsule Endoscopy 

Compared to Colonoscopy in Detection of 

Colon Polyps and Cancers: Analysis of a 

Prospective Multicenter European Study 

J. Devière, Hôpital Erasme, Brussels, Belgium 

Devière presented an analysis of a multicenter European study 

of detecting colon polyps and cancers using CCE with the 

PillCam COLON compared to colonoscopy. Final analysis 

covered prospective data from 320 patients from 8 sites in 

Belgium, France, Germany, Italy, Spain, and the UK. He 

noted that in pilot studies, CCE with PillCam COLON has 

been shown to be safe and able to visualize colon polyps and 

cancers. This study was conducted with the primary objective 

to assess the accuracy of PillCam COLON to colonoscopy. 

Patients included in this study were known to have (age ≥ 18 

years) or were suspected of having (age ≥ 50 years) colonic 

disease and were referred for colonoscopy. Patients received 

a standard PEG-based colon prep and ingested the PillCam 

COLON video capsule in the morning. The PillCam COLON 

procedure / regimen also included a prokinetic medication and 

additional small doses of laxatives. No sedation, tube insertion, 

or air insufflation was required. Independent physicians 

performed CCE interpretation and colonoscopy (gold 

standard) after PillCam COLON video capsule excretion. 

Review of PillCam COLON and colonoscopy studies was by 

double-blinded review process. 

Results: A total of 328 patients (mean age: 59 years; range: 

22-84) were enrolled; 320 were included in the final analysis. 

There was 1 severe adverse event related to colonoscopy. 

PillCam COLON video capsules were excreted within 10 

hours post-ingestion in 93% of the patients and within 6 hours 

in 69%. Quality of colon cleansing was evaluated according 

to a 4-point scale; 72% of the patients had colon cleansing 

levels of Good-to-Excellent. Accuracy parameters for polyp 

detection with PillCam COLON compared to colonoscopy 

were particularly encouraging for Good-to-Excellent colon 

cleansing levels. See Tables 1-3. 

Table 1. Reasons for Referral 

Patients known 

to have colonic disease 

Patients suspected of 

having colonic disease 

Age 18-49 y Age ≥ 50 y All 

patients 

57 58 115 (35%) 

7 206 213 (65%) 

All patients 64 (19.5%) 264 (80.5%) 328 

Table 2. PillCam COLON Findings and Accuracy (Compared to 

Colonoscopy) 

Findings No. of 

Patients 

Sensitivity Specificity Positive 

Predictive 

Value 

*PillCam COLON has received a CE Mark, but is not cleared for marketing or available for commercial distribution in the USA. 

Negative 

Predictive 

Value 

In patients with Good-to-Excellent cleansing levels (72% of all 

patients) 

Any size 

polyps 

Significant 

finding* 

149 76% 80% 88% 63% 

93 75% 83% 75% 83% 

Polyp ≥ 6 59 75% 84% 62% 90% 

Polyp ≥ 10 33 76% 98% 89% 96% 

In all patients (n=320) 

Any size 

polyps 

Significant 

finding* 

212 72% 78% 86% 59% 

134 66% 82% 72% 77% 

Polyp ≥ 6 87 64% 84% 60% 86% 

Polyp ≥ 10 50 60% 98% 83% 93% 

* At least 1 polyp ≥ 6 mm or ≥ 3 polyps of any size. 

References 

Note: Throughout this document, the term colonoscopy refers to conventional optical colonoscopy. 

Conclusions: CCE with PillCam COLON is a new minimallyinvasive 

and safe technology for visualizing the colon. PillCam 

COLON shows encouraging accuracy for detecting polyps 

compared to colonoscopy and may be an alternative for patients 

who cannot or are unwilling to undergo colonoscopy. 

1. Devière J, Schoofs N, Munoz Navas M, Fernandez-Urien I, Carretero 

C, Lapalus MG, Ponchon T, Gay G, Delvaux M, Neuhaus H, Philipper M, 

Costamagna G, Riccioni ME, Spada C, Fraser C, Postgate A, Fitzpatrick 

A, Hagenmuller F, Keuchel M, Van Gossum A. PillCam COLON capsule 

endoscopy compared to colonoscopy in detection of colon polyps and cancers. 

Gastroenterology 2008;134(4)(suppl 1):A-38. 

2. Eliakim R, Fireman Z, Gralnek IM, Yassin K, Waterman M, Kopelman Y, 

Lachter J, Koslowsky B, Adler SN. Evaluation of the PillCam Colon capsule in 

the detection of colonic pathology: results of the first multicenter, prospective, 

comparative study. Endoscopy 2006;38(10):963-970. 

3. Schoofs N, Devière J, Van Gossum A. PillCam Colon capsule endoscopy 

compared with colonoscopy for colorectal tumor diagnosis: a prospective pilot 

study. Endoscopy 2006;38(10):971-977. 

4. Lewis B, Rex D, Lieberman D. Capsule colonoscopy- an interim report of 

a pilot 3 arm, blinded trial of capsule colonoscopy, virtual colonoscopy and 

colonoscopy. Am J of Gastroenterol 2006;101(suppl II):1470.

Colon Capsule Endoscopy Regimen 

The current baseline regimen for CE with PillCam COLON 

is shown in Table 3. Several sessions at ICCE Berlin covered 

ongoing research on new prep and procedure variations 

(including day vs night procedures) in studies presented by 

S. Bar-Meir (Israel), T. Brechmann (Germany), C. Carretero 

(Spain), G. Costamagna (Italy), Z. Fireman (Israel), and M. 

Table 3. Baseline Colon Prep and Procedure (Regimen Used in Multicenter European Study) 

Schedule Colon prep and procedure 

Day before Clear liquid diet all day (no breakfast) + 3 L Colopeg ® 

Exam day 6:00 – 7:00 1 L Colopeg 

7:45 – 8:00 20 mg Domperidone + (after 15 min) PillCam COLON ingestion 

10:00 *Booster I: 45 mL NaP 

Only if needed 14:00 Booster II: 30 mL NaP 

16:30 10 mg Bisacodyl suppository 

*Pending exit of PillCam COLON from the stomach (verified via RAPID Real-Time device) 

Philipper (Germany). Presentations by M. Delvaux (France) 

and H. Schulz (Germany) on PillCam COLON experience in 

regional studies also included variations of the base regimen in 

office-based, clinic-based, and hospital settings which evaluated 

daily workflow for CE of the colon. 

93% of patients in the European multicenter study completed the PillCam COLON exam and excreted the capsule 

within 10 hrs post-ingestion; 69% completed the PillCam COLON exam without need for Booster II and within 6 hrs. 


Note the different views of colon mucosa: With insufflation in colonoscopy, polyps can appear flattened; PillCam COLON 

images the mucosa through clear fluid without using insufflation. 

Colonoscopy PillCam COLON 

Pedunculated polyp in transverse colon 

Polyp in right colon 

ICCE Workshop Report Vol. 1 3 

Colonoscopy PillCam COLON 

Small polyps in rectum 

Polypoid mass in right flexure 

*PillCam COLON has received a CE Mark, but is not cleared for marketing or available for commercial distribution in the USA.


IBD and Mucosal Healing 

The potential role of CCE in evaluating colonic inflammatory 

bowel disease and mucosal healing was an important topic 

at the <strong>workshop</strong>. The presentation by J. J. Y. Sung (Hong 

Kong) of interim clinical results of the first pilot study 

using PillCam COLON for evaluating ulcerative colitis was 

received with enthusiasm. J. F. Colombel (Belgium) discussed 

the various needs for evaluating mucosal injury and healing 

in ileocolonic Crohn’s disease. During question-and-answer 

sessions, panel members and the audience discussed applying 

existing tools such as the Lewis Score (integrated in RAPID 

5) for characterizing colonic lesions, as well as other areas of 

future study. 

Evaluation of PillCam COLON Capsule 

Endoscopy in the Assessment of Colonic 

Inflammatory Lesions in Ulcerative Colitis: An 

Interim Analysis 

J. J. Y. Sung, Chinese University of Hong Kong, Hong 

Kong, China 

Introducing this interim analysis, Sung emphasized that active 

ulcerative colitis (UC) is associated with an increased risk of 

colorectal dysplasia and cancer. Treatment of UC should be 

closely monitored and follow the level of severity of colonic 

inflammation. There is also a need for surveillance of CRC 

especially in patients with extensive disease for prolonged 

periods. In previous studies, CCE with PillCam COLON has 

been shown safe and able to demonstrate colon polyps and 

cancer. The primary objective of this ongoing pilot study was 

to evaluate the accuracy of capsule endoscopy with the PillCam 

COLON in monitoring colonic inflammation and UC in 

comparison to colonoscopy. 

Inclusion criteria were patients 18-70 years old referred to 

colonoscopy for suspected or known inflammatory lesions or 

other colonic disease. Patients had a traditional PEG colon 

prep and ingested the video capsule in the morning. The 

PillCam COLON procedure was designed to enhance capsule 

propulsion and maintain clean colon during the procedure. No 

sedation, intubation, or insufflation was required. Following 

capsule excretion, colonoscopy (gold standard) was performed 

the same day. Independent physicians performed PillCam 

COLON and colonoscopy evaluations. UC disease was activity 

classified into 1 of 3 groups (according to findings): 

1. Normal or not related to UC (polyps, vascular lesions, 

diverticulitis) 

2. Non-active UC (pseudopolyps, scarring, mosaic pattern, 

cobblestoning) 

3. Active UC (ulcer, erythema, erosions, edema, exudates, 

proctitis) 

Results: 42 patients (mean age: 48 years; range: 27-68) were 

enrolled; 40 included in the interim analysis. No adverse events 

were related to the PillCam COLON video capsule. Capsules 

were excreted within 8:30 hours post-ingestion in 97.5% of the 

patients and within 5:30 hours in 60%. Colonoscopy detected 

active UC in 22 patients, and the accuracy of PillCam COLON 

compared to colonoscopy was 77% sensitivity, 78% specificity, 

81% PPV, and 74% NPV. The agreement level (kappa) between 

PillCam COLON and colonoscopy 

of classifying the UC disease 

into 1 of the 3 groups was 0.6. 

See Tables 4 and 5. 

Conclusions: CCE with PillCam 

COLON is a safe and well-tolerated 

procedure. It has encouraging 

accuracy for detection of active 

UC and substantial agreement with 

colonoscopy. The high acceptability 

of PillCam COLON may increase 

adherence to monitoring activities 

in UC patients. 

Areas of future research: 

• Development of a scoring system 

for the assessment of the severity 

of colonic inflammation in UC by 

using PillCam COLON in order 

to tailor individual treatment 

• Use of PillCam to define the 

extent of disease involvement in 

UC using PillCam COLON 

• Use of PillCam COLON in 

surveillance for cancer 

Table 4. Reasons for Referral 

No. of 

Patients 

Abdominal 

Pain 

10 (25%) � 

Ulcerative 

Colitis 

23 (57%) � 

Rectal 

Bleeding 

4 (10%) � 

2 (5%) � � 

1 (3%) � � � 

Table 5. Classification of UC Activity (Per Patient Analysis) 

Colonoscopy 

PillCam 

COLON 

Normal / not 

related to UC 

Non-active 

UC 

Normal / not 

related to UC 

12 

(80%) 

0 

Non-active 

UC 

Active 

UC 

0 4 

2 

(67%) 

Active UC 3 1 

Classification of 

Colonoscopy (left colum 

Pseudopolyps; flattened 

insufflation at 

1 

17 

(77%) 

Substantial agreement between PillCam COLON and colonoscopy 

(kappa statistic = 0.6). 


Diffuse

Ulcerative Colitis Disease Activity 

n) and PillCam COLON Views of UC 

erythema 

appearance at left due to 

colonoscopy 

J. J. Y. Sung, Chinese University of Hong Kong, Hong Kong, China 

Following is a case where colonoscopy was incomplete because 

of the presence of a sigmoid stricture while the PillCam 

COLON video capsule allowed a complete examination of the 

colon. CCE enabled detection of colonic polyps proximal to 

the sigmoid stricture that would have otherwise been missed; 

it was reliable in localizing the site of the findings (confirmed 

at repeat colonoscopy) both for polyps and colonic Crohn’s 

Colonic polyps missed at incomplete colonoscopy 

Large sessile polyp > 10 mm 

suggestive of 

adenomatous polyp 

Erosions 

Small sessile polyp < 6 mm 

suggestive of 

hyperplastic lesion 


Erosions, edema, 

erythema 

Severe erosions, edema, 

erythema 

Pseudopolyps Mosaic pattern 

disease; it also provided accurate estimation of polyp size when 

compared to colonoscopy as a gold standard. 

Furthermore, PillCam COLON findings guided therapy 

(medical treatment of colonic Crohn’s disease and polypectomy) 

and improved patient management and outcomes. The patient 

is in good clinical condition after 18 months of follow-up. 

PillCam COLON Complements Incomplete Colonoscopy 

Colonic Crohn’s disease in same patient 

Erosions, narrowing, and 

ulcer in left colon 

C. Spada, Catholic University and European Endoscopy Training Center, Rome, Italy 


Hyperemia, ulcerations 

in rectum 

Active UC Non-Active UC


Economics of CRC Screening 

At the ICCE Workshop on Colon Capsule Endoscopy a 

number of presentations covered different aspects of CRC 

screening—especially the potential of CCE with PillCam 

COLON to improve patient compliance, and subsequently 

improve outcomes. W. Schmiegel (Germany) discussed 

indications for screening and surveillance of high-risk groups 

such as patients with a family history of CRC and hereditary 

nonpolyposis colon cancer (HNPCC), familial adenomatous 

polyposis (FAP), and Peutz-Jeghers syndrome (PJS). 

For the first time at ICCE, an economic modeling study was 

presented on CCE in the average-risk, general population 

that fails to comply with current CRC screening guidelines; 

C. Hassan (Italy) concluded that PillCam COLON may be 

a cost-effective approach to preventing CRC in this general 

patient population. This study was also published in the May 

issue of Endoscopy. 

Cost-effectiveness of Colorectal Cancer 

Screening with Capsule Endoscopy 

C. Hassan, Nuovo Regina Margherita Hospital, Rome, 

Italy 

Hassan pointed out that CRC screening rates remain 

disappointingly low when compared to the success of other 

cancer screening programs. Colorectal cancers are preventable 

through early detection, and this minimally-invasive option 

may aid in significantly reducing the more than 212,000 

annual deaths in Europe due to colorectal cancer. The aim 

of this analysis was to provide a model to assess the cost 

and effectiveness of population-based screening for CRC 

using capsule endoscopy compared with that of a standard 

colonoscopy screening program. 

A Markov mathematical model was constructed to simulate a 

comparison of CRC screening scenarios comparing PillCam 

COLON with standard colonoscopy. Model parameters were 

varied to simulate alterations in cost, thresholds for treatments, 

sensitivities and specificities, and screening adherence rates. 

Through pooled analyses, it was determined that a threshold 

≥ 6 mm for polypectomy referral substantially reduced costs 

while only minimally impacting efficacy. 

[Editor’s Note: Markov models are useful when a decision 

problem involves risk that is continuous over time, when the 

timing of events is important, and when important events may 

happen more than once.] 

Conclusions: Cost-effectiveness of CRC screening using 

PillCam COLON will mainly depend on its ability to 

improve compliance in the general population. The very low 

adherence achieved by colonoscopy prompts an urgent need 

for minimally-invasive alternatives, such as capsule endoscopy. 

(See Figures 1 and 2.) The impact of compliance on the 

effectiveness of CE is substantial, that of efficacy marginal; 

a minimally-invasive CE strategy also implies a filter for 

post-CE [polypectomy] referrals. Based on uptake for CE in 

other areas of the GI tract (small bowel, esophagus), there is 

ubiquitous expectation that CE will achieve better acceptance 

and thus will increase compliance to screening. If such uptake 

Figure 1. Crucial Role of Patient Compliance in the 

Effectiveness of CRC Screening 

Clinical 

Efficacy 

The impact of compliance on the effectiveness of CE is 

substantial, that of efficacy marginal. Thus, cost-effectiveness 

of CRC screening using PillCam COLON will mainly depend 

on its ability to improve compliance in the general population. 

The very low adherence achieved by colonoscopy prompts 

an urgent need for minimally-invasive alternatives, such as 

capsule endoscopy. PillCam COLON holds great promise 

in improving compliance to CRC screening standards in the 

general population. 

mirrors that for other cancer screenings, CE will be an efficient 

strategy for CRC prevention, with cost-effectiveness potentially 

superior to colonoscopy. PillCam COLON holds great promise 

in improving compliance to CRC screening standards in the 

general population. 

References 

EFFECTIVENESS 

of CRC screening 

Patient 

Compliance 

EFFECTIVENESS = Efficacy x Compliance 

Figure 2. Cost-effectiveness CE vs Colonoscopy 

Colonoscopy compliance = 18% 

300,000 

250,000 

200,000 

150,000 

100,000 

0 

0% 10% 

Compliance (%) 

20% 30% 40% 50% 

Compliance (%) 

60% 70% 

1. Hassan C, Zullo A, Winn S, Morini S. Cost-effectiveness of capsule 

endoscopy in screening for colorectal cancer. Endoscopy. 2008 Feb (E Pub). 

2. Sonnenberg FA, Beck JR. Markov models in medical decision making: 

a practical guide. Med Decis Making. 1993 Oct-Dec;13(4):322-38. http:// 

www.ncbi.nlm.nih.gov/pubmed/8246705. 


Cost/life-year saved ($) 

50,000 

Colonoscopy 

BETTER 

CE compliance 

threshold 

26% 

CE BETTER

CRC Screening and Other Indications 

Several presentations focused on studies and patient cases using 

PillCam COLON for CRC screening as well as other indications 

complementing colonoscopy, ie, patients unwilling or unable to 

have colonoscopy. S. Chaussade (France) presented interim data on 

behalf of the French Ministry of Health research grant consortium 

(PHRC) study led by J. Galmiche (France). In his conclusions, 

Chaussade emphasized the “excellent acceptability and tolerance 

of PillCam COLON in patients screened for colonic neoplasia.” 

During presentations of the patient cases (this page), there 

were interactive questions to the audience that stimulated lively 

discussions on challenging aspects of the different cases and patient 

management strategies involving CCE and follow-up modalities. 

Note: Images not marked PillCam COLON are from colonoscopy. 

Adenomatous polyps 

CRC screening of patient with family history of adenomatous polyps; she 

presented with occasional upper gastric pain and reflux; no weight loss or 

anemia/bleeding. CCE findings: Multiple polyps were identified. 

Post-CCE: Colonoscopy and polypectomy of 6 polyps was performed: 

4 were adenomas. Patient is well and scheduled for follow-up colonoscopy 

in 2 years. 

M. Philipper, Evangelisches Krankenhaus, Duesseldorf, Germany 

Hyperplastic polyps 

Patient presented with upper- and mid-abdominal pain for 6 months and 

had normal bowel habits, no visible blood in stool, and no weight loss. CCE 

findings: 4 polyps were detected. Post-CCE: colonoscopy and polypectomy 

were performed: 4 hyperplastic polyps (1 polyp was > 1 cm in transversum). 

M. Keuchel, Asklepios Klinik Altona, Hamburg, Germany 


Serrated adenoma in sigmoid colon 

CRC screening of asymptomatic patient with hypertension and no personal 

or family history of colonic polyps or cancer. Patient refused colonoscopy 

and requested a minimally-invasive, comfortable method of CRC screening. 

CCE findings: Pedunculated polyp in sigmoid colon was detected. 

Post-CCE: Based on CCE findings, patient agreed to colonoscopy (to 

confirm CCE findings) and polypectomy. Histological diagnosis: serrated 

adenoma. Patient is well and scheduled for follow-up in 1 year. 

J. M. Herrerías, Hospital Universitario Virgen Macarena, Seville, 

Spain 

Hyperplastic polyp 

Patient presented for regular CRC screening (for adults ≥ 55 years 

old, according to regional guidelines) with no major complaints except 

infrequent diarrhea. CCE findings: 1 small polyp was detected. Post-CCE: 

colonoscopy was performed; polyp was removed during biopsy. Histologic 

diagnosis: hyperplastic polyp. Patient is well with no symptoms after 1 year. 

A. Sieg, Gastroenterologische Schwerpunktpraxis, Heildelberg, 

Germany 

Tubulovillous adenoma in rectosigmoid colon 

Patient had complaints of constipation alternating with diarrhea and no 

weight loss, no anemia/rectal bleeding. She had prior history of breast 

cancer (surgery, chemotherapy) and chronic GERD. CCE findings: Polyp in 

the rectosigmoid colon was detected. 

Post-CCE: Biopsies via colonoscopy were performed. Histological 

diagnosis: tubulovillous adenoma, moderate but focal high-grade dysplasia. 

Surgery: Resection (15 cm) of the rectosigmoid by laparoscopy. Follow-up 

colonoscopy showed absence of lesion at > 1 year post-surgery. Patient is 

well and next follow-up is in 3 years. 

A. Van Gossum, Erasme Hospital, Brussels, Belgium 



Workflow and Practical Guidelines 

Recipients of Awards Presented at ICCE 

The European Capsule Endoscopy Group (ECEG), established during United European 

Gastroenterology Week (UEGW) 2004 in Prague, initiated the ECEG Research Grant 

“to support innovative research in gastroenterology with substantial involvement in 

capsule endoscopy.” At ICCE Berlin, Chairman of the ECEG Research Grant Committee 

T. Ponchon (France) announced the recipients of the 2008 grants: 

• Principal Investigator I. Fernández-Urién (Spain) for a pilot, prospective 6-site 

multicenter study on the role of CE in patients with Stage III-IV melanoma. 

• Prinicipal Investigator H. Glerup (Denmark) and the research team of B. Larsen, R. Oestgaard, B. Deuleran for their study 

using CE to evaluate Crohn’s disease in ankylosing spondylitis. 

See www.CapsuleEndoscopy.org for online application information for ECEG Research Grants. 

Many thanks to those who contributed to this ICCE Workshop Report. 

Visit www.ICCE.info for important information on the conference and 

www.CapsuleEndoscopy.org for more information on capsule endoscopy. 

See you at the next ICCE. 

Ellen F. Bodner, Editor, ICCE Workshop Report 

As with any new modality, colon capsule 

endoscopy involves a learning process—the 

PillCam COLON video capsule is unique 

in enabling direct visualization of colon 

mucosa through clear fluid without using 

insufflation. 

J. M. Herrerías (Spain) and M. E. Riccioni 

(Italy) gave presentations that focused on 

practical guidelines and how CCE can fit 

into the workflow of a GI practice. Riccioni 

described the various RAPID features for 

effective reading of PillCam COLON videos 

as well as tips for using: 

• Schematic Colon Track, a tracing tool for 

localization allowing convenient and quick 

identification of the colon section being 

viewed (right, transverse, or left colon) 

• Image Enhancement and Adjustment 

• Polyp Size Estimation 

At the conclusion of the <strong>workshop</strong>, Herrerías proposed detailed diagnostic algorithms for CCE for CRC prevention and other 

indications for colonic examination. Such algorithms can stimulate discussion and future studies about where CCE with PillCam 

COLON fits in the workflow with other diagnostic modalities. 

In his closing remarks at the <strong>1st</strong> International ICCE Workshop on Colon Capsule Endoscopy, co-chair G. Costamagna (Italy) 

concluded: 

“This is only the beginning—the best is yet to come.” 

To learn more about CCE, visit www.CapsuleEndoscopy.org or contact your Given Imaging representative for educational 

opportunities such as courses, presentations at <strong>international</strong> congresses, professional societies, and local capsule clubs. 

This ICCE Workshop was sponsored by 

Copyright ©2001-2008 Given Imaging Ltd. GIVEN, GIVEN & Design, PILLCAM, PILLCAM & 

Logo, PILLCAM IMAGING CAPSULE & Design, AGILE, RAPID, RAPID ACCESS, ORDERWIN, 

ORDER WHEN I NEED, FINGERS HOLDING A CAPSULE & Logo, FINGERS HOLDING 

PILLCAM CAPSULE & Logo, ICCE, ICCE Logos, and INTERNATIONAL CONFERENCE ON 

CAPSULE ENDOSCOPY are Trademarks and/or Registered Trademarks of Given Imaging Ltd., its 

subsidiaries, and/or affiliates in the United States and/or other countries. All other company or product 

names are the trademarks or registered trademarks of their respective holders. All rights not expressly 

granted are reserved. 

GMB-0331-01

1st international workshop on colon capsule endoscopy

Create successful ePaper yourself

Delete template?

Save as template?